{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T21:15:04Z","timestamp":1790025304854,"version":"4.0.1"},"reference-count":17,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2012,9]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>The aim of this study was to determine the incidence of motor nerve injuries during the minimally invasive lateral interbody fusion procedure at a single academic medical center.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>A retrospective chart review of 118 patients who had undergone lateral interbody fusion was performed. Both inpatient and outpatient records were examined to identify any new postoperative motor weakness in the lower extremities and abdominal wall musculature that was attributable to the operative procedure.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>In the period from 2007 to 2011 the lateral interbody fusion procedure was attempted on 201 lumbar intervertebral disc levels. No femoral nerve injuries occurred at any disc level other than the L4\u20135 disc space. Among procedures involving the L4\u20135 level there were 2 femoral nerve injuries, corresponding to a 4.8% injury risk at this level as compared with a 0% injury risk at other lumbar spine levels. Five patients (4.2%) had postoperative abdominal flank bulge attributable to injury to the abdominal wall motor innervation.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The overall incidence of femoral nerve injury after the lateral transpsoas approach was 1.7%; however, the level-specific incidence was 4.8% for procedures performed at the L4\u20135 disc space. Approximately 4% of patients had postoperative abdominal flank bulge. Surgeons will be able to minimize these motor nerve injuries through judicious use of the procedure at the L4\u20135 level and careful attention to the T-11 and T-12 motor nerves during exposure and closure of the abdominal wall.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2012.5.spine1288","type":"journal-article","created":{"date-parts":[[2012,6,29]],"date-time":"2012-06-29T14:05:42Z","timestamp":1340978742000},"page":"227-231","source":"Crossref","is-referenced-by-count":119,"title":["Motor nerve injuries following the minimally invasive lateral transpsoas approach"],"prefix":"10.3171","volume":"17","author":[{"given":"Kevin S.","family":"Cahill","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph L.","family":"Martinez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael Y.","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Vanni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan D.","family":"Levi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-spine1288","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"139","DOI":"10.3171\/2008.10.SPI08479","article-title":"An anatomical study of the lumbosacral plexus as related to the minimally invasive transpsoas approach to the lumbar spine. Laboratory investigation","volume":"10","author":"Benglis","year":"2009"},{"key":"b2-spine1288","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"11","DOI":"10.3171\/2011.2.SPINE10374","article-title":"An analysis of postoperative thigh symptoms after minimally invasive transpsoas lumbar interbody fusion. Clinical article","volume":"15","author":"Cummock","year":"2011"},{"issue":"3","key":"b3-spine1288","series-title":"Neurosurg Focus","doi-asserted-by":"publisher","first-page":"E8","DOI":"10.3171\/2010.1.FOCUS09282","article-title":"Early outcomes and safety of the minimally invasive, lateral retroperitoneal transpsoas approach for adult degenerative scoliosis","volume":"28","author":"Dakwar","year":"2010"},{"issue":"4","key":"b4-spine1288","series-title":"Neurosurg Focus","doi-asserted-by":"publisher","first-page":"E18","DOI":"10.3171\/2011.7.FOCUS11164","article-title":"Abdominal wall paresis as a complication of minimally invasive lateral transpsoas interbody fusion","volume":"31","author":"Dakwar","year":"2011"},{"key":"b5-spine1288","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"290","DOI":"10.3171\/2010.10.SPINE10395","article-title":"Trajectory of the main sensory and motor branches of the lumbar plexus outside the psoas muscle related to the lateral retroperitoneal transpsoas approach. Laboratory investigation","volume":"14","author":"Dakwar","year":"2011"},{"key":"b6-spine1288","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"532","DOI":"10.3171\/2011.7.SPINE10887","article-title":"Avoiding abdominal flank bulge after anterolateral approaches to the thoracolumbar spine: cadaveric study and electrophysiological investigation. Laboratory investigation","volume":"15","author":"Fahim","year":"2011"},{"key":"b7-spine1288","series-title":"Arch Surg","doi-asserted-by":"publisher","first-page":"753","DOI":"10.1001\/archsurg.1994.01420310085015","article-title":"The retroperitoneal incision. An evaluation of postoperative flank \u2018bulge\u2019","volume":"129","author":"Gardner","year":"1994"},{"key":"b8-spine1288","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"280","DOI":"10.3171\/2011.4.SPINE1127","article-title":"Nerve injury during the transpsoas approach for lumbar fusion. Report of 2 cases","volume":"15","author":"Houten","year":"2011"},{"key":"b9-spine1288","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"454","DOI":"10.3171\/SPI.2008.9.11.454","article-title":"Cosmetic and functional outcomes following paramedian and anterolateral retroperitoneal access in anterior lumbar spine surgery. Clinical article","volume":"9","author":"Jagannathan","year":"2008"},{"key":"b10-spine1288","series-title":"J Spinal Disord Tech","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1097\/BSD.0b013e3181679b8a","article-title":"Direct lateral lumbar interbody fusion for degenerative conditions: early complication profile","volume":"22","author":"Knight","year":"2009"},{"issue":"4","key":"b11-spine1288","series-title":"Neurosurg Focus","doi-asserted-by":"publisher","first-page":"E4","DOI":"10.3171\/2011.7.FOCUS11137","article-title":"Minimally invasive lateral lumbar interbody fusion and transpsoas approach-related morbidity","volume":"31","author":"Moller","year":"2011"},{"key":"b12-spine1288","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1097\/01.BRS.0000049226.87064.3B","article-title":"An anatomic study of the lumbar plexus with respect to retroperitoneal endoscopic surgery","volume":"28","author":"Moro","year":"2003"},{"key":"b13-spine1288","series-title":"Spine J","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1016\/j.spinee.2005.08.012","article-title":"Extreme Lateral Interbody Fusion (XLIF): a novel surgical technique for anterior lumbar interbody fusion","volume":"6","author":"Ozgur","year":"2006"},{"key":"b14-spine1288","series-title":"J Clin Neurosci","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1016\/j.jocn.2010.07.109","article-title":"Contralateral femoral nerve compression: An unrecognized complication after extreme lateral interbody fusion (XLIF)","volume":"18","author":"Papanastassiou","year":"2011"},{"key":"b15-spine1288","series-title":"J Spinal Disord Tech","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1097\/BSD.0b013e3181a9d540","article-title":"The relationship of intrapsoas nerves during a transpsoas approach to the lumbar spine: anatomic study","volume":"23","author":"Park","year":"2010"},{"key":"b16-spine1288","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"260","DOI":"10.3171\/2010.3.SPINE09766","article-title":"Defining the safe working zones using the minimally invasive lateral retroperitoneal transpsoas approach: an anatomical study. Laboratory investigation","volume":"13","author":"Uribe","year":"2010"},{"key":"b17-spine1288","series-title":"Hernia","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1007\/s10029-009-0473-6","article-title":"Abdominal wall paresis as a complication of laparoscopic surgery","volume":"13","author":"van Ramshorst","year":"2009"}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/17\/3\/article-p227.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/17\/3\/article-p227.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/17\/3\/article-p227.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,16]],"date-time":"2023-04-16T00:09:32Z","timestamp":1681603772000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/17\/3\/article-p227.xml"}},"subtitle":["Clinical article"],"short-title":[],"issued":{"date-parts":[[2012,9]]},"references-count":17,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/2012.5.spine1288","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2012,9]]}}}